Tags

Type your tag names separated by a space and hit enter

Efficacy of TNFα blockers in patients with ankylosing spondylitis and non-radiographic axial spondyloarthritis: a meta-analysis.
Ann Rheum Dis. 2015 Jun; 74(6):1241-8.AR

Abstract

OBJECTIVES

This meta-analysis investigates the efficacy of tumour necrosis factor α (TNFα) blockers versus placebo for the treatment of ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA).

METHODS

A systematic literature search was conducted independently by two reviewers. Double-blind randomised controlled trials (RCTs) investigating the efficacy of adalimumab, certolizumab, etanercept, golimumab or infliximab in approved dosages in comparison with placebo were included. The use of concomitant non-steroidal antirheumatic drugs was allowed. The outcome parameters were improvement in disease activity and function measured by the Bath AS disease activity index (BASDAI), Bath AS functional index (BASFI) and ASAS40 response. The effect sizes of the changes in BASDAI/BASFI between TNFα blocker and placebo comparator groups were calculated. Mixed effect models were applied separately for RCTs with AS and nr-axSpA patients and differences between those groups were evaluated in a joint model.

RESULTS

20 studies with data from 3096 patients were included in the analysis: 15 studies with AS patients, four with nr-axSpA patients and one with both. For AS patients, TNFα blockers showed better efficacy than placebo for BASDAI (effect size 1.00), BASFI (effect size 0.67) and ASAS40 response (OR 4.7). For nr-axSpA patients, the differences were smaller (effect sizes 0.73, 0.57; OR 3.6). However, after adjustment for the year of publication as a proxy for disease severity, no differences in the effect sizes between the AS and nr-axSpA trials were observed.

CONCLUSIONS

Compared with placebo, TNFα blockers improve disease activity and functional capacity clinically meaningful for both AS and nr-axSpA patients.

Authors+Show Affiliations

Epidemiology Unit, German Rheumatism Research Centre, Berlin, Germany.Medical Department I, Rheumatology, Charité University Medicine Berlin, Campus Benjamin Franklin, Berlin, Germany.Epidemiology Unit, German Rheumatism Research Centre, Berlin, Germany.Epidemiology Unit, German Rheumatism Research Centre, Berlin, Germany Department of Rheumatology and Clinical Immunology, Charité University Medicine Berlin, Campus Mitte, Berlin, Germany.Epidemiology Unit, German Rheumatism Research Centre, Berlin, Germany.

Pub Type(s)

Journal Article
Meta-Analysis
Review

Language

eng

PubMed ID

24718959

Citation

Callhoff, Johanna, et al. "Efficacy of TNFα Blockers in Patients With Ankylosing Spondylitis and Non-radiographic Axial Spondyloarthritis: a Meta-analysis." Annals of the Rheumatic Diseases, vol. 74, no. 6, 2015, pp. 1241-8.
Callhoff J, Sieper J, Weiβ A, et al. Efficacy of TNFα blockers in patients with ankylosing spondylitis and non-radiographic axial spondyloarthritis: a meta-analysis. Ann Rheum Dis. 2015;74(6):1241-8.
Callhoff, J., Sieper, J., Weiβ, A., Zink, A., & Listing, J. (2015). Efficacy of TNFα blockers in patients with ankylosing spondylitis and non-radiographic axial spondyloarthritis: a meta-analysis. Annals of the Rheumatic Diseases, 74(6), 1241-8. https://doi.org/10.1136/annrheumdis-2014-205322
Callhoff J, et al. Efficacy of TNFα Blockers in Patients With Ankylosing Spondylitis and Non-radiographic Axial Spondyloarthritis: a Meta-analysis. Ann Rheum Dis. 2015;74(6):1241-8. PubMed PMID: 24718959.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy of TNFα blockers in patients with ankylosing spondylitis and non-radiographic axial spondyloarthritis: a meta-analysis. AU - Callhoff,Johanna, AU - Sieper,Joachim, AU - Weiβ,Anja, AU - Zink,Angela, AU - Listing,Joachim, Y1 - 2014/04/09/ PY - 2014/01/30/received PY - 2014/03/23/accepted PY - 2014/4/11/entrez PY - 2014/4/11/pubmed PY - 2015/7/29/medline KW - Ankylosing Spondylitis KW - Anti-TNF KW - Spondyloarthritis KW - Treatment SP - 1241 EP - 8 JF - Annals of the rheumatic diseases JO - Ann. Rheum. Dis. VL - 74 IS - 6 N2 - OBJECTIVES: This meta-analysis investigates the efficacy of tumour necrosis factor α (TNFα) blockers versus placebo for the treatment of ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nr-axSpA). METHODS: A systematic literature search was conducted independently by two reviewers. Double-blind randomised controlled trials (RCTs) investigating the efficacy of adalimumab, certolizumab, etanercept, golimumab or infliximab in approved dosages in comparison with placebo were included. The use of concomitant non-steroidal antirheumatic drugs was allowed. The outcome parameters were improvement in disease activity and function measured by the Bath AS disease activity index (BASDAI), Bath AS functional index (BASFI) and ASAS40 response. The effect sizes of the changes in BASDAI/BASFI between TNFα blocker and placebo comparator groups were calculated. Mixed effect models were applied separately for RCTs with AS and nr-axSpA patients and differences between those groups were evaluated in a joint model. RESULTS: 20 studies with data from 3096 patients were included in the analysis: 15 studies with AS patients, four with nr-axSpA patients and one with both. For AS patients, TNFα blockers showed better efficacy than placebo for BASDAI (effect size 1.00), BASFI (effect size 0.67) and ASAS40 response (OR 4.7). For nr-axSpA patients, the differences were smaller (effect sizes 0.73, 0.57; OR 3.6). However, after adjustment for the year of publication as a proxy for disease severity, no differences in the effect sizes between the AS and nr-axSpA trials were observed. CONCLUSIONS: Compared with placebo, TNFα blockers improve disease activity and functional capacity clinically meaningful for both AS and nr-axSpA patients. SN - 1468-2060 UR - https://www.unboundmedicine.com/medline/citation/24718959/Efficacy_of_TNFα_blockers_in_patients_with_ankylosing_spondylitis_and_non_radiographic_axial_spondyloarthritis:_a_meta_analysis_ L2 - https://ard.bmj.com/cgi/pmidlookup?view=long&pmid=24718959 DB - PRIME DP - Unbound Medicine ER -